Family Welfare & RCH

REPRODUCTIVE AND CHILD HEALTH IMMUNIZATION

Reproductive and child Health II – Flexi pool

The most important goals of National Health Mission is to reduce maternal and Child mortality rate which is covered under RCH II programme of the mission. Huge and strategic investments are being made to achieve these goals by GoI, and every effort is being made towards achieving these goals.

In order to bring greater impact through the RCH programme, Reproductive Maternal, Newborn, Child & Adolescent Health (RMNCH+A) an integrated strategy has been adopted in February 2013 because of the well known link between maternal and child survival and the use of family planning methods.

The two dimension of health care i.e. stages of the life cycle and places where the cares provided constitute the “continuum of care”. The continuum of care approach defining and implementing evidence based packages of services for different stages of the life-cycle at various levels has been adopted under National Health Program. The ‘plus’ in the strategic approach denotes:-

  • The inclusion of adolescence as a distinct ‘life stage’ in the overall strategy.
  • Linking maternal and child health to reproductive health and other components (like Family planning, HIV, Gender, PC & PNDT)
  • Linking of community and facility based care as well as referrals between various levels of health care systems and to bring a synergistic effect in terms of overall outcomes and impact.

The major component covered under RCH II flexi pool is:-

  • Maternal Health
  • Child Health, RBSK & Immunization
  • Family planning
  • Adolescent Health
  • PC & PNDT
  • Tribal RCH

Maternal Health

Service Delivery

State has made considerable progress over the past in health sector towards service provision for maternal health which is further accelerated under National Health Mission by improving the availability and accessibility to health care by the people especially the women and the children. The progress made so can be seen from the maternal Health indicators which are as follows:

MATERNAL HEALTH INDICATORS STATUS

Indicators
NHFS III (2005-06)
NHFS IV (2015-16)
UNICEF CES 2009
DLHS IV (2012-13)
014-15 (HMIS)
015-16 (HMIS)
3 ANC
69.4
74.7
87.3
94
88.4
88.1
ID
49
94.7
68.9
82.7
98
98.4
MMR * by AN
NA
NA
NA
-
15
08
TFR
2.02
1.2
-
-
-
-
Anaemia (PW)
58.5
23.6
-
74.9
-
-
TT (PW)
-
-
94.2
DLHS 3
99.4
86.9
87.3
*Maternal deaths by Absolute Number (AN) Maternal Health indicators target:-
  • Maternal deaths to < 10,

  • 100% 3 ANC ,

  • 100% ID and by 2017

Anaemia among PW to <50%

The performance of three ante natal check up has shown an improvement from 69.9% in DLHS III (2007-08) to 94% in DLHS IV (2012-13), and institutional delivery (ID) has gone up from 49.8% in DLHS III (2007-08) to 82.7% in DLHS IV (2012-13). Drastic decline is seen in maternal deaths which have come down from twenty six (26) in 2012-13 to eight (08) in 2015-16. Total Fertility Rate of 2.0 of the state has been projected as below the replacement level.

The Maternal Health services are implemented by provision of the following strategies & activities.

  • Compulsory registration of pregnant women by 1st trimester under Mother and Child Tracking System (MCTS).
  • Use of MCP card for all Pregnant Women and continuing the same with the newborn.
  • Provision of Safe Motherhood booklet to all ANC mother during first ANC registration.
  • Ensuring home delivery by Skilled Birth Attendant (SBA) trained health worker in hard to reach area by provision of incentive to the health worker.
  • Ensuring adequate supplies at all the health facilities as per 5×5 matrix from GoI.
  • Continuing Skilled based capacity building as per Skill Lab GoI guidelines.
  • Continuing supervision and monitoring from the state and districts by the concerned programme officers.
  • Implementation of all the schemes for promotion of institutional deliveries like JSY and JSSK.
  • Operationalisation of First Referral Unit (FRU) and 24×7 PHC is another strategy to provide quality health care services, however non-availability of specialist and medical officers is major concern in making all the FRUs and 24×7 PHC functional as per Indian Public Health Standards (IPHS) norms.

Schemes for promoting Institutional Delivery:

The specific services packages for mothers to encourage institutional delivery include;

  • Janani Surakshya Yojana (JSY),
  • Janani Sishu Surakshya Karyakaram (JSSK) and
  • Mukhya Mantri Shishu Suraksha Ayam Sutkeri Sahayoj Yojana (MMSSASSY) (State Scheme).

i. Janani Surakshya Yojana (JSY) status;

Year
rch_table-.htmlHome Delivery
rch_table-.htmlInst. Delivery
rch_table-.htmlTotal JSY Beneficiaries
rch_table-.htmlFinancial Progress (Rs in lakhs)
    
Target
rch_table-.htmlAch. (%)
Target
Ach. (%)
Target
Ach. (%)
Target
Ach. (%)
014-15
400
10

(2.5)
3000
2268

(75.6)
3400
2278

(67)
31.25
26.69
(85)
015-16
100
3

(3)
1650
2821

(>100)
1750
2824

(>100)
22.50
48.34

The mode of payment for JSY was made through DBT – AADHAR based payment from January 2013. Most of the payment could not be made because of mothers not having AADHAR number of bank account or some places had no nationalized banks. This may be one of the reasons for having decline in the number of beneficiaries this year; However, GoI has been intimated for relaxation for the Sikkim to allow account payee cheque payment in some remote places where bank facilities are not available.

ii. Janani Sishu Surakshya Karyakaram (JSSK)

This scheme is to promote institutional delivery was implemented since November 2011 with issue of Government Order on 10.10.11 on free diagnostics and treatment for all mothers having delivery at the health facility, all sick neonates and this scheme is further extended sick infant from 2013. There is provision of Rs.350/- for normal delivery and Rs.1,600/- for each cesarean section and Rs.1,000/- for referral transport from home to facility and back.

JSSK status:

Pregnant Women availing Free Entitlement of Service Delivery:

year
target
Free Drugs & Consumables
Free Diet
Free Diagnostics
Free Blood
2014-15
7136
5723

(80%)
8653 (121%)
6125

(85%)
69

(1%)
2015-16
8620
6158

(71%)
5398

(62%)
5656

(66%)
130

(1.5%)

Pregnant Woman availing Referral Transport (RT) Services

Year
Target
Referral transport availed
State Vehicle
EMRI/ EMTS
PPP
Others
Total (%)
2014-15
7136
Home to health institution
405
118
2612
3135(43)
Transfer to higher level facility for complications
513
72
384
969(13)
Drop back home
353
109
2163
625(37)
2015-16
Home to health institution
1424
0
125
2088
3637(42)
Transfer to higher level facility for complications
824
8
50
359
1241(14)
Drop back home
240
4
92
1478
1814(21)

Awareness and orientation of health functionaries and ANC mothers on the JSSK schemes is being continued through health education and publicity by the IEC division to improve implementation activities.

Maternal Death Review (MDR)

Maternal Death Review (MDR) implemented since 2010 with constitution of MDR Committees at State/ district/ block and facility based MDR Committee. All maternal deaths are reported and reviewed as per the MDR Guidelines. Data are being analyzed and corrective interventions are being taken up to further prevent future maternal deaths

Year
STNM
CRH
East
West
North
South
Total
Remark
2011-12
9
4
3
2
5
2
25
Main causes of Maternal Death were found to be Hemorrhage, PPH, Sepsis & other causes

like anaemia
2012-13
6
6
6
2
1
5
26
2013-14
5
2
-
-
2
2
11
2014-15
7
4
1
1
0
2
15
2015-16
3
1
1
2
0
1
8

Maximum death is found to be occurring at STNM/CRH and these cases are mostly referred cases from districts. One of the important corrective interventions to be taken up is making the FRUs fully operational in terms of manpower, infrastructure, equipments & blood storage facilities. Except for the north district all the other district are functioning as FRU.

Reproductive Tract Infection / Sexually Transmitted Infections (RTI/STI):

The RTI/ STI services are being provided in collaboration with State Aids Control Society (SACS) and this is being continued focusing on quality service delivery. The services are provided through designated RTI/ STI Clinics (located at STNM Hospital, CRH & 4 districts) and all PHCs. The drugs are provided from RCH II for all PHCs while for the designated clinics by the SACS. Provisions of quality services at delivery points are ensured in convergence with SACS.

Support & services are being continued to all these clinics in terms of supply of consumables and capacity building. State hospital and 4 districts are conducting trainings and till date there are 14 Master trainers in place and 115 Health functionaries which includes MO, LHV, ANM & lab technician are trained. (SACS report.)

RTI/STI cases reported (HMIS):-

Particulars
014-15
015-16
Number of new cases of RTI/STI in males for which treatment was initiated
548
546
Number of new cases of RTI/STI in females for which treatment was initiated
4854
5118
Total number of new cases of RTI/STI in males and females
5402
5664
Number of suspected RTI/STI cases for whom wet mount test was conducted
0
0

Village Health & Nutrition Day (VHND):

VHND is organized at the AWC as per the GoI norms and is a platform for assured and predictable packages of outreach services. These days are utilized to reach woman & communities in the most remote part of the state. So far it has contributed to increase of immunization and ANC, however the services for newborn, child health & nutrition is still to be improved. Necessary intervention measures are being taken care of by having VHND in each ICDS centre for each AHSA from 2014-15.

Expanded packages of services in VHND:

  1. Immunization as per schedule
  2. Antenatal care including birth preparedness and complication readiness
  3. Post-natal care to mothers including counseling for contraception
  4. Facilitating access to contraceptive services
  5. Growth monitoring
  6. Counseling on key practices for improved newborn and child health and nutrition
  7. Demonstration on preparing and use of ORS and Zinc, and provision of ORS and Zinc for treatment of childhood diarrhea
  8. Follow up care of several malnourished children
  9. Testing and treatment for anaemia in pregnant women
  10. Referral support to ASHAs, AWWs in community level care, for children with illness
  11. Sessions and services for adolescent girls and boys

District wise Village Health & Nutrition Day (VHND) performance

District
VHND conducted during last three years
  
013-14
014-15
015-16
East
2817
2853
2807
North
946
1085
1105
South
1809
1832
1690
West
2158
2684
3143
Total
7730
8454
8744

Delivery point:-

Delivery points are those health facilities which fulfills the Government of India criteria of minimum bench mark of performance in terms of delivery conducted right from PHSCs to districts hospitals. The provision of services for delivery generally serves as an important indicators to access whether the facilities is operational or not. The designated DP where deliveries are conducted should be the first to be strengthened for providing comprehensive RMNCH+A services.

GoI Benchmark for delivery points:- ( source MNH Tool KiT)

Health facility
For all other States
North- East states
Sub- centers
> 3 deliveries per month
> 2 deliveries per month
Primary Health Centers
> 10 deliveries per month
> 6 deliveries per month
Non- first Referral Units (FRU)/Community Health Centers (CHC)
> 10 deliveries per month
> 6 deliveries per month
FRU- CHC/ Sub district Hospital (SDH)
> 20 deliveries per month
> 20 deliveries per month
District hospital/ District Women Hospital
> 50 deliveries per month
> 30 deliveries per month
Medical Colleges
> 50 deliveries per month
> 50 deliveries per month
Accredited PHF
> 10 deliveries per month
> 10 deliveries per month

Health facilities functional as Delivery point as per GoI benchmark in the state.

Year
PHSC
PHC
District Hospital
State Hospital
Medical College
012-13
Nil
East ; Pakyong, North : NIL

Rangpo South: Jorthang

Rhenock Yangang

Rongli

West: Dentam

Richenpong

Sombaria

Tashiding PHC,
Namchi Gyalshing Singtam
STNM Hospital
Manipal Hospital
013-14
Three PHSCs;
Simik Lingay Bermiok Daramdin)
East ; Pakyong, North : NIL

Rangpo South: Jorthang

Rhenock Yangang

Rongli

West: Dentam

Richenpong

Sombaria

Tashiding PHC,
Namchi Gyalshing Singtam
STNM Hospital
Manipal Hospital
014-15
Four PHSCs; Simik lingay, Bermiok, Daramdin, Samdong Kaluk
East ; Pakyong, North : NIL

Rangpo South: Jorthang

Rhenock Yangang

Rongli

West: Dentam

Richenpong

Sombaria

Tashiding PHC,
Namchi Gyalshing Singtam
STNM Hospital
Manipal Hospital

Maternal Health Training:-

Apart from training outside the State, training within the State is conducted at State & District hospital by the trained resource persons under RCH II programme

  1. Emergency Obstetric care (EmOC) & Life saving Anaesthetic Skills ( LSAS) trained doctors status:
EmOC
  
Sl.no
Name of the Doctor
Place of posting
1
Dr. Indu Rawat
Posted in Namchi DH
2
Dr. Hemlata Pradhan
gone for higher studies
3
Dr. Annet. Thattal
Resigned
4
Dr. Pema Seden
Posted in Mangan DH
5
Dr. ManiGurung
State Hospital
6
Dr. Solomit Lepcha
Posted in Emergency STNM hospital
7
Dr. Upashana. Rai
gone for higher studies
LSAS
  
Sl.no
Name of the Doctor
Place of posting
1
Dr. Ugen Bhutia
Left for PG
2
Dr. Prabat Moktan
resigned
3
Dr. Tshering Wangchuk
Left for PG study

As far as LSAS & EmOC trained doctors are concerned, they are to be posted at FRUs to compliment the Gynecologist and Anesthetists in providing maternal health services at FRUs & CHCs. Rational posting of these doctors is a priority in the State and this is proposed every year for information of the higher authorities and to take necessary action.

  1. Basic emergency obstetric care (BEmOC) trained doctors status:

A total of 32 medical officers are trained for Basic Emergency Obstetric Care (BEmOC) from 2012-13 to 2015-16.

  1. Training on RTI/STI

This year 2 batches of Medical Officer,1 batch of laboratory technician, and 1 batch of ANM were trained in RTI/STI.

  1. Skilled Birth Attendant (SBA) training status:

Staff nurses and ANM are trained on Skilled Birth Attendant (SBA) every year. These trainings are conducted at the respective districts. However, the trainings for the east and north district for this year was conducted at STNM Hospital due to various technical problems (Less Case load).

Two hundred and ninety eight (298) ANMs & Staff Nurses have been trained up to 2015-16.

  1. Blood Storage:

I. Two- day North East Zonal Workshop on Strengthening of Blood Services was held on 18th and 19th November 2015 at Hotel Rendezvous, Gangtok. The participants for this zonal workshop were the Mission Directors, Nodal officers & Blood Coordinators working under blood strengthening services and Medical Officers of Blood Banks and Blood Storage Centers of North Eastern States. Ms. Vinita Srivastava National Consultant Blood Cell along with the resource persons from various institutions also attended the programme.

II. Medical Officer In charge blood bank, Namchi, Medical Officer In charge Blood Storage, Singtam along with three Laboratory technician attended one month training on blood strengthening at Tata institute Mumbai from 1st March to 31st March 2016.

VI. Comprehensive Abortion Care (CAC):-

Comprehensive Abortion Care (CAC) is planned for all 4 districts and state where Gynecologists are in place. However, Safe abortion services are being extended to the CHCs & delivery points after training of Medical officers of these facilities in 2014-15. These are being taken up as per the MTP Act which is extended in the state since 19th June 2007. as per State Gov. notification No537/dated 5th December 2007.With clinical establishment and State and district level committee under MTP Act-1971 in place, reporting from all private clinics are also being ensured.

District
Number of MTPs conducted up to 12 weeks of pregnancy
Number of MTPs conducted for more than 12 weeks of pregnancy
North
7
1
South
0
0
East
13
2
West
0
0
Total
20
03

CHILD HEALTH

The implementation activities under this component include immunization, promotion of optimal Infant and young Child Feeding Practices (IYCF), prophylaxis for anaemia, management of ARI, and diarrhoea with ORS etc.

Under NHM, Newborn Care Corners at all delivery points, Newborn Stabilization Unit at Singtam, Gyalyzing and Mangan District hospital and Sick Neonatal Care Unit at STNM Hospital and Namchi District Hospital have been set up for reducing neonatal and infant mortality.

Further, comprehensive implementations of Facility Based Integrated Management of Neonatal and Child Illness (F-IMNCI), Integrated Management of Neonatal and Child Illness (IMNCI) and Navjat Sishu Suraksha Karyakam (NSSK) have also been introduced for skill development of the health personnel at all levels.

Janani Sishu Suraksha Karakam (JSSK) scheme has been implemented in providing free drugs and consumables, free diagnostics, free blood, free diet & free referral system for newborns & infants admitted in health facilities.

The problems of malnutrition and anaemia are being addressed through close coordination with link workers at the village level. Special intervention methods are adopted to address the problem of anaemia through observed consumption of IFA tablets by all school children along with biannual de-worming.

Strategy and Activities

  • Strengthening facilities to provide new born care services through new born care corners in all 24 PHCs next to the delivery rooms with emergency resuscitation kits and drugs.
  • Setting up of SNCU and NBSU being done in phased manner for district hospitals. Equipment and Furniture for NBSU have been proposed for all the four District Hospital.
  • Comprehensive training of health functionaries including medical officers in IMNCI, F- IMNCI and NSSK.
  • Strengthening of Routine Immunization.
  • Introduction of Common Mother & Child Health Cards to cover complete ANC / PNC and Child Health services along with growth chart plotting.
  • Implementation of Mother and Child Tracking System.
  • Ensure adequate supply of essential drugs, ORS, Vitamin-A. IFA and de worming tablets.
  • Promotion of Optimal IYCF practices.
  • Extensive IEC activities and counselling services on child health.

Child Health Indicators (SIKKIM)

Particulars
Source
Sikkim
India
Crude Birth Rate (CBR)
SRS 2014
17.1
21.4
Infant Mortality Rate (IMR)
SRS 2014
19
40
Initiation of Breast Feeding within 1 hr of birth
DLHS 4
61.4
-
Exclusive breast feeding for 6 months
CES 2009
63.6
36.8
ORT or increased fluid for diarrhoea
CES 2009
63.5
53.6
Care seeking for acute respiratory infection
CES 2009
91.2
82.6
Anaemia in children
NFHS 4
55.1
-
Infant and Under 5 deaths (2015-16)
 
Early Neonatal Deaths
48 (30%)
Late Neonatal Deaths
23 (14%)
Post Neonatal Infant Deaths
77 (48%)
Under 5 deaths
14 (8.6%)
TOTAL
162

Newborn and Child Care Status

The thrust areas for newborn and child health under NRHM are:-

  • Immediate routine newborn care and care of the sick newborns.
  • Child nutrition including essential micronutrients supplementation.
  • Immunization against common childhood diseases, management of common neonatal and childhood illnesses.
  • The main implementation activities include essential new born care through operationalization of Special Newborn Care Unit, New Born Stabilizing Unit and New Born Care Corner at all delivery points with deployment of skilled manpower.

ANMs trained in NSSK are posted at all delivery points to provide skilled and quality services. Efforts are being made to increase and improve institutional deliveries at these delivery points with basic newborn care services.

Facility Based Care of the Sick Newborns

  • SNCUs have been established at STNM and Namchi District Hospital to strengthen the care of the sick, premature and low birth weight newborns. SNCUs provide advance care for sick newborns and serve as a referral center for the entire district and information for their optimum utilization has been made available to all the peripheral health facilities.
  • NBSU (smaller unit) a 4 bedded unit providing basic level of sick newborn care have been established at district hospital, Singtam, Gyalzing and Mangan for moderately sick newborns.
  • Newborn Care Corners (NBCCs) have been setup in all the delivery points, PHCs and CHCs in one corner of labour room with provision of radiant warmer and emergency resuscitation kits and drugs for provision of essential newborn care at birth.
  • Janani Sishu Suraksha Karyakam (JSSK) :-

All sick Infants including newborns requiring facility based newborn care will receive free referral from home to facility and back, along with free diagnostic and drugs during their stay at the health facilities.

Home Based Newborn Care (HBNC) and Prompt Referral

Reducing mortality in neonatal period is paramount if the IMR is to be impacted. The HBNC scheme launched in 2011 provides immediate post natal care especially in home delivery and essential care to all newborns upto 42 days of age. ASHAs are trained and incentivized to provide special care to preterm’s and newborns. ASHAs are also trained in identification of illnesses, appropriate care and referral through home visits. Newborns discharged from SNCUs are followed up by the frontline workers like ASHAs and Health Workers.

Child Nutrition and Essential Micronutrients Supplementation

  • One of the key preventive interventions in decreasing IMR is the promotion of optimal IYCF practices. The 1st two years of life is considered a critical window of opportunity for prevention of growth faltering. Optimal breast feeding and complementary feeding practices allow children to reach their full growth potential. The various opportunities of maternal and child health contacts are used to reinforce the key messages around infant and young child feeding, growth monitoring and promotion. Line listing of babies with low birth weight maintained by ANMs and ASHAs and follow up done to support mothers for optimum feeding and child care practices and to detect growth faltering early before it progresses to moderate to severe under nutrition.
  • To decrease anemia prevalence, IFA tablets / syrup are given to children in aganwadi centers and Government and government aided schools under School Health Programme. 6 monthly de-worming (albendazol tablet or syrup) to decrease intestinal parasite load.
  • Vitamin ‘A’ supplementation for children between the age group of 9 month to 5 years at 6 monthly interval upto 9 doses is given.

Integrated Management of Common Childhood Illnesses (diarrhoea and pneumonia)

An integrated strategy which includes both preventive and curative interventions to address the most common causes of neonatal and child deaths known as IMNCI has been adopted. Training on IMNCI and F-IMNCI to comprehensively address childhood illnesses of all health functionaries have been taken up.

Diarrhoea and pneumonia are major cause of infant death. Supply of ORS and zinc tablets is ensured at all health facilities and frontline workers. Intensified Diarrhoea Control Fortnight (IDCF) campaign was implemented in the state during 2014-15 for creating awareness on diarrhoea & the importance of Zinc sulphate tablet & ORS in the management of diarrhoea.

Since 2014 Intensive Diarrheal Control fortnight (IDCF) is observed from 11th July to 23rd July with the goal to attain zero child deaths due to childhood diarrhoea. The main objective of IDCF is to improve awareness on use of ORS and zinc for childhood diarrhoea and to compliment awareness for management and prevention of diarrhoea in under five children.

For non severe pneumonia in children aged 2 month to 5 years, health workers have been trained to give antibiotic based on national guidelines.

Timely and prompt referral of cases with fast breathing and chest in-drawing are made to higher facilities. Hospital based care and management of children with severe diarrhoea and pneumonia is done by doctors and nurses specially trained in F-IMNCI.

Performance on Child Health as per HMIS report 2015-16
 
Total Live Births
7703
No. of still births
130
No. of newborn weighed at birth
7316
No. of newborns having weight less than 2.5 kgs.
568
No. of newborns breast fed within 1 hr.
6125
Number of cases of Measles reported in children below 5 yrs of age
44
Number of cases of Diarrhoea and Dehydration reported in children below 5 yrs of age
8157
Number of children below 5 yrs of age admitted with Respiratory Infection
1348

Other Activity

National Deworming Day (NDD) for all children in the age group 1-19 years was observed on 28th March 2016. The objective of NDD is to improve the overall health, nutritional status, access to education and quality of life of children. All the children enrolled in government, government aided and private schools, anganwadi centers and out of school children were deworm on that day.

Total number of Government school covered
718
Total private school covered
380
Total AWW covered
1128
Total children (1-19yrs) administered tab albendazole
143434

Introduction

Child sex ratio statistics in the 0-6 age group for the last four decades show a continuous decline in the country, with sharpest fall from 1981 onwards. The main factors influencing Child Sex Ratio is deep-rooted prejudice and discrimination against girl child. The fall to 918 in 2011 census from 927 in 2001 and 945 in 1991 has been alarming especially when country seems to be registering an upward growth in other areas. This clearly indicates that economic prosperity and education have no bearing on sex ratio or in changing the traditional preference for sons over daughters.

Sex ratio in the context of Sikkim:

Socio-culturally the indigenous populations of Sikkim (Bhutias, Lepchas and Nepalese) have no gender bias and do not have practices prevalent in some other part of the country like exorbitant dowry and the belief that only son can perform last rites or men are the bread earner of the family etc. But we also have a considerable size of population who are from the region where above practices and beliefs mentioned are highly prevalent.

Mild preferences for son have been reported by NFHS 2 survey among married women in Sikkim. In another survey conducted among married men from rural Sikkim, mild preference for boy child has been reported. However there is no data or studies to say whether Female foeticide or sex selective abortion is prevalent or not in the state. The child sex ratio as per census 2011 which is 957 females / 1000 males is among the best in the country (ranks 8th in the country) and is within or very close to the normal sex ratio at birth. The natural estimated range is 950 girls to 975 boys (lancet 2011; Guidance: Ensuring Access to Safe Abortion and Gender Biased Sex Selection, MHFW GoI, Feb’2015)

Sex ration status: Sikkim/India

Year (Census)
Sikkim
National
Adult
1981
835
934
1991
878
927
2001
875
933
2011
890
940
0-6 years
1981
978
979
1991
965
945
2001
963
927
2011
957
918
Target:2014-15: 950/1000 males: 2015-16: 960/1000males: 2016-17 : 970/1000 males

District wise sex ratio status

Sex ratio per 1000males
     
Year (Census)
State
North
East
South
West
1991
878
828
859
892
915
2001
875
752
844
892
929
2011
890
769
872
914
941
Child sex ratio 0-6 years
2001
963
995
950
969
966
2011
957 (-19)
929 (-66)
960 (+10)
953 (-16)
964 (-02)

North district taken as critical district under Beti Bachao Beti Padhao Scheme among 100 districts in the country. (CSR down by -66 females from 995 in 2001 to 929 in 2011 census report) BBBP scheme is under the process of implementation by the WCD department with full coordination from the health department.

The PC & PNDT Act 1994, implementation:

The PNDT Act is a Comprehensive piece of legislation which prohibits misuse of Pre-Conception and Pre-Natal Diagnostic Techniques for determination of sex of the fetus leading to female foeticide.

The Act also specifies the punishment for violation of its provisions. Complaints of violations of any provisions of the Act can be lodged by anybody with the Appropriate Authority. All bodies, under PNDT Act, namely Genetic Counseling Centre, Genetic Laboratory or Genetic or USG Clinic cannot function unless registered with the Appropriate Authorities under the PC & PNDT Act.

The PC & PNDT Act 1994, implementation Sikkim status

The PC& PNDT Act 1994 was brought into operation in the state of Sikkim since 1996.The supervisory Board and committees have been constituted for the effective implementation of the Act both at state and district level i.e. all the Statutory Bodies are in place.

At the State level

  1. State Supervisory Board
  2. State Appropriate Authority
  3. State Advisory Committee and its functions:

Constituted as per the Notification No.100/HC, HS & FW dated 17/9/2013.

At the District level (four districts)

  1. District Appropriate Authority:
  2. Advisory Committee:

Constituted as per the Notification No.100/HC, HS & FW dated 17/9/2013.

List of Chairperson of State/ District Level Appropriate Authorities under PC & PNDT Act 1994, Sikkim State as per Government Order notification no.99/HC,HS & FW dated 17/9/2013

Sl.No.
Name Address/ Designation
Telephone no.
1
Dr. D.S Kerongi, C.M.O South,

District Appropriate Authority (PNDT),

District Hospital Namchi, South Sikkim,

Department of Health Care, Human Service and Family Welfare.
03595-26333 (O)

9434136948 (M)
2
Dr. Thinlay Wongyal, C.M.O West,

District Appropriate Authority (PNDT),

District Hospital Gyalshing, West Sikkim,

Department of Health Care, Human Service and Family Welfare.
03595-251089(O)

9733076770 (M)
3
Dr. T. Laden, C.M.O East,

District Appropriate Authority (PNDT),

District Hospital Singtam, East Sikkim,

Department of Health Care, Human Service and Family Welfare.
03592-235379 (O)

9434178992 (M)
4
Dr. Barun Subba, C.M.O North,

District Appropriate Authority (PNDT),

District Hospital Mangan, North Sikkim,

Department of Health Care, Human Service and Family Welfare.
03592-234244(O)

9434117251(M)


5
Dr. Namgay Shenga, Joint Director (RCH),

State Appropriate Authority (PNDT),

PNDT Cell, Room No:108, Health Secretariat, Tashiling

Department of Health Care, Human Service and Family Welfare,

Government of Sikkim.
03592-202886 (O)

9434338717 (M)

Detail Address and User Name of Ultrasound Clinics in the state of Sikkim

Sl. No.
Name of the Centre with postal address
Name of User
1
STNM Hospital, Gangtok, Sikkim

737101
Dr K.Giri (Radiologist),

STNM Hospital
2
Gynae & Obstetric Department, STNM Hospital, Gangtok, Sikkim

737101
Dr. R.N. Deokata (Gynaecologist)

Dr. Paras Mani Kharka (Gynaecologist)

STNM Hospital
3
Cardiology Department, STNM Hospital, Gangtok, Sikkim

737101
Dr. Kumar Bhandari

(Cardiologist)

STNM Hospital
4
Central Referral Hospital, 5th mile Tadong, Gangtok-737102, Sikkim

  1. Dr.S.K Khanna (Radiologist),

  2. Dr. Barun Sharma (Radiologist),

  3. Dr. B.K Kanungo (Gynaecologist)
5
Ruchi Diagnostics Clinics (P) Ltd,

Behind Telephone Exchange, National Highway, Gangtok, Sikkim 737101
Dr K.Giri (Radiologist),
6
Jagriti Diagnostic Centre, Opposite LIC Housing, Gairi Gaon, Tadong, Gangtok, Sikkim 737101
Dr. Anup Pradhan (Gynaecologist)

Dr. Robina Bhandari, Sonologist
7
Sukhim Diagnostics & Research Center, Nam nang Road, Gangtok, Sikkim 737101
Dr. Tenzing K Tonyot, Sonologist

Dr.K.N Sharma (Radiologist),
8
City Diagonistic Centre & Poly Clinic, Tadong, Dara Gaon.
Dr. Barun Sharma (Radiologist)

Dr. Mona Dhakal (MD Medicine/ Echo Cardiogram)
9
Ashirwad Clinic, 5th Mile,
Dr. Neeti Nepal (Gynaecologist)
10
District Hospital Singtam, East Sikkim-737134
Dr.M.P Sharma (Gynaecologist)
11
Mobile Medical Unit
Dr.J.B Gurung (Gynaecologist)
12
Kanchendzonga Diagnostic & Ploy Clinic Centre
Dr. J. B Gurung (Gynaecologist)
13
District Hospital Mangan OBG Clinic, North Sikkim-737116
Gynaecologist on duty
14
Mobile Medical Unit
Gynaecologist on duty
15
District Hospital Gyalshing, West Sikkim-737111
Gynaecologist on duty
16
Mobile Medical Unit
Gynaecologist on duty
17
District Hospital Namchi, South Sikkim-737126
Dr. Annie Rai, Sonologist

Dr. Uttam Kharka (Gynaecologist) on duty
18
Mobile Medical Unit,
Dr. Uttam Kharka (Gynaecologist) on duty

Mandatory Committee meeting conducted for 2015-16:

1
State Advisory Committee meeting on PC & PNDT Act
2/5/15

  • Meeting chair by DG cum Secretary, Health

2
State Supervisory Board meeting on PC & PNDT Act
10/3/15

  • Meeting chair by Hon. Minister, Health

3
State Advisory Committee meeting on PC & PNDT Act
1/6/15

  • Meeting was chaired by Director Health Services-I

4
State Advisory Committee meeting on PC & PNDT Act
22/7/15

  • Meeting was chaired by Director Health Services-I

5
State Supervisory Board meeting on PC & PNDT Act
7/9/15

  • Meeting chair by Hon. Minister, Health

6
State Advisory Committee meeting on PC & PNDT Act
4/9/15

  • Meeting was chaired by Director Health Services-I

7
State Advisory Committee meeting on PC & PNDT Act
03/12/15

  • Meeting was chaired by Director Health Services-I

8
State Advisory Committee meeting on PC & PNDT Act
03/03/16

  • Meeting was chaired by Director Health Services-I

9
State Supervisory Board meeting on PC & PNDT Act
06/02/16

  • Meeting chair by Hon. Minister, Health

Other activities conducted at State and District level (2015-16)

    1. State Level orientation of health workers was held on 12th, 13th and 15th January 2016.
    2. Medical Officers from districts were oriented and sensitized on PC & PNDT Act. on 19th March 2016
    3. Orientation of Appropriate Authority on PC & PNDT Act. on 21st March 16.
    4. Orientation of Judiciary on 23rd, 29th and 30th March 2016
    5. Advertisement of Detail Address and User Name of Ultrasound Clinics in the state of Sikkim was given in Sikkim Express (31st March 2016).
    6. Supervision and monitoring from the state by State monitoring team having State Appropriate Authority/ State Nodal Officer , Legal officer and DEO (PNDT)conducted on quarterly basis. At times the supervision is conducted along Clinical establishment team.